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APPLICATION FOR SANITATION PERMIT <br /> (Complete in Duplicate) Date Issued ---I <br /> iplication is hereby made to the San Joaquin Local Health 'District for a permit to construct and install the work herein described. <br /> llp <br /> This application is made in compliance with County Ordinance No. 549: <br /> Installation will serve: Residence X Apartment House E] Commercial E] Trailer Court [-] Motel E] Other E] <br /> Number of living units: ----1--Number of bedrooms 35--- Number of baths __;k Lot size ------ ----------- <br /> Water Supply: Public system x Community system J-] Private [I Depth to Wafer Table4/-4?ft. <br /> Character of soil to a depth of 3 feet: Sand E] Gravel E] Sandy Loam E] Clay Loam El Clay El Adobe Hardpan L] <br /> Previous Application Made: Yes El No�� New Construction: Ye No F1 <br /> SX- <br /> TYPE OF INSTALLATION AND SPECIFICATIONS: <br /> (No septic tank or cesspool permitted if public sewer is available within 200 feet.) <br /> Septic Tank: Distance from nearest wellJ��Disfance f4r <br /> Disposal Field: Distance from nearest wellAP-_L___._DiVs_fance from founclafion---/5-----------Distance to nearesf4of lineg.------------ <br /> See e Pit: Distance to nearest well-I -------Distanc Tom f undation__JJ_" Distance fo nearest lot line-- ----- <br /> 7 4:��4-----Size: Diameter-----_3--" <br /> Remodeing and/or repairing [describe):-------------------------------------------------------------------------------------------------------------------------- ------------------ <br /> _-- '____-_---_.----__---_-__.-'_--__-_---__.____---.---'___.____----_-_' <br /> --'---------------------------'------------------'----------'-------`''--'----'—' <br /> --_.-..___..__--__'--____-__-___.__-_-_-.___.._____--___.-_._.___-__-.__-----_--._. <br /> hereby certify that | have prepared this application and that the work will be done in accordance wifk San Joaquin County <br /> ordinances, State laws District. <br /> (Signed)- -- . � � <br /> B-� � - � � f . . (Tlt|oL '� �� <br /> � mmf �/�mfo�n. JcTmmsystem in n°|afion +o ~eUs. 6u||6|ngs, etc., can <br /> )' <br /> 6e placed on reverse �@mL ` <br /> FOI:�P.ER�RTMENT USE ONLY <br /> 8U|LD|NG PERMIT ISSUED------------------------------------------------------------------------------------------------------- DATE- -__...-_-._-�--'______ <br /> Alterationsand/or recommendations:----------------------------------------------------------------------------------------------------------------------------------------------- <br /> --------------- <br /> ------------------------------------------------------------------------------'-_'''--'___'-'--'-'''----'''-_-''-''----'-'_-''--'__------.'_- � <br /> --_.--_._--_-----.-_-._��---_���-_---------_�--__'-�-__._�------_-._--------._-_--_ ^ <br /> -_-._---'---''-'-''''--'''--''-_.''----'''--'-'-_'''---'''--''''---'--'''__.''''''-''_-''-''_-.-_' . <br /> ----'�_�'-'--'�'-'��''�����''_���'-'''''--''-'''--. -''-'''''-''----''''-'--'''''__--''--''-''--'--_� <br /> � <br /> FIN/\L INSPECTION BY-------- --------------------------------- Date--------- -y� '--'-''-_'�--'' | <br /> ' <br /> SAN J[AQU|N LOCAL HEALTH DISTRICT <br /> oo South American Street 30D West Oak Sfreet /am Sycamore Streeo|+ North ^c^ Street <br /> Stockton, California Lodi, California Manteca, California Tracy, California <br /> ES-9-2M u-S/ no,i"vd vv-2/0u <br />